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64-61 - 145 Canal Street - CONSERVATION COMMISSION P s t"Qha� c,� tit \�WN Col, Conservation Commission Salem, Massachusetts 01970 '�F U Telephone (617( 745.5056 ASSi May.12, 1980 Richard Salinsky B.P. GAS STATION RE.: 145 Canal Street, Salem, Mass. - 319 Lynnway Lynn, Massachusetts " Dear Mr. Salinsky: Enclosed you will find the "Order of Conditions" for 145 Canal Street Salem, Massachusetts DEQE #64-61 that was voted by the Conservation Commission at their meeting on May 8, 1980. I would also like to inform you at this time that there is a 10 day appleal period to these "Order of Conditions." If you have any questions relevant to these "Orders of Conditions," please do not hesitate to call at 745-5056. Thank you for your cooperation in this matter. Very truly yours, " Sheila Morin " Clerk Encl IL � GLc-Al O /. New 6, ol7d 9 7Z. fame 2 rcq-. s 13, 3 4 o g al —_--0 o/o U 7of 7Z s/on ra9e capac/fy 331350 „ 67 , ,3. /Fcd.Tachet submergediovr7710 4 HP., /z "dl scha,-g e, p with leap ooefecfor � 2 0 to s¢• heavy duf y 177.717 - hole .{�rovia�e ernerger/cy valve under dis/en.ser. -� 4, 4 'Ftl line , With 2 ''vent, caaxial vapor recovery _5ys- -76 a temp fight Fill adapter cap, manhole. '13.6 ell d ooerf n die 8 �a• , IS , was 5 , , � . / • • ` : . NOTES /, 6C/alls of eXcavaf,or7 sfiall6e as close` as ,voSsibLe to the verf.oCaL. \�\ 2, Sac%Fi I Gvifh clean coarse sar?d fo a 17-7c7X/177(J17.7 o'cpfh \ ® of /-'6" well cofnpacted fo create a cvsh,on, Top Nr//h clean/ well graded (na stones over .3 ) bank rrin yia✓eL \ �J- Exisi-pumpisl. i Fvll f> corrioacfecl 1i7 a manr>ei such as r>of to _q�amaq e G tx t`/7 c fahksfhei.- apperf�rnar>ces © ��m 3, Hold down as�c'rr� bly shall, consist 01Z "0S1eel rope EL•/2.o' ('9Tmin.,nom1r7,,-1 slrenyfh) with 2cows ho/ asps,a/1 ,1; /7eoL7rer)P /pose cover (�.sPo�) , f'vrr>buc%leS sf� - `-- 70,0 3 ' --' hook �71-7e-bo,- 5' e °L9, eoafPa/ with 2 eoafs hod asphalt <-v/>Eic e rt�c� erl fro /roLr7cl, -- C fl /l/ A L 0 T 14. Concrete .a. <Jll mafPrials, Erection r vor/ m ars sliiP dial/b e / _ T P L. A lLI t6 /'o' ire accoro✓a»cam wiffi 11-helafesf standards oF1hP RECEIVED .J " — - -- -- - - - b Conciefe sfrPnc�><h shat! he 3 ODoPsi X28 da s air 80 APR 14 P2:53 f's f I o'w y er�lrainec/ (� / _) 4 "r77? 214 SlurrlP. 701AC/7 , /Op Of 17 o f'o fhP mlx (CITSALEMKM OFFICE 9s*,` ` r bl y furni.h a wry en a�F, avit a�e�tin ds 4"11q toward na_ afch eX�sf. strength of concrete Poured. ,... feral drainage paving P� IWA1 shall be .1185 steel v re9uirec✓ d E. 00.5ea/ s�ab surface shall have a b.-oorr, N 6X1 WIA � v S — Gravel fiLf -�� �o UPL/ F� 7- OA Ta Q W LU see note 2. �1 27.7 /_.-17k 6', 67o c�al/fan� , ;� ✓ Q O Z =-= - - �`�\ � � _ fotaL uPliF>r 0670X2 XO,l3� 7xo.oE2¢- 112 k 4 � \ c of 6 "Gonc .Pael eQ surlaePr2s'xi� ')= V W Standar steel °' ` i o.isxo,sr2sxra = .. 34ftX IQ, 7 � Q Tnk wi hUL _ /2 " subrnerc�Pr/ (e 5'xI,S) . laf�el_a ched >, = J �i to c�P1Se ---�0,1s_D.o524�zs rlg_ 39h / ¢ " h o�Aovt f -- Tanhs = r7T7X2s. ► _ 5.67 h Q _` : o. �1 5.53X-2 1 /2 h ✓ �' ti O 1, ItF'l/ abovP hoffom l'ad Z Z o f m W Ulu V ' ro. i-O ,o62�) (ZSXiBxto-3,S71-X2sx2�= 42hX W Q CO � Sanc/ Fi l,sPPhotP2 - r o 's7so Com'' = t,770) '7y\h �► � IIZ h vpCt �f Z . y • 17 V a .. 172 6 ,, . E " WK1149 hold dokun assemhly_ ¢ _ 9 - O '¢" 6 4re�v�ircdpPi� tar�tz , ,. /8.o" X25'2 ' 1 a7 6- 4 p.c. nate 3 T A _iAj _K_ U . U N 0 A T / 0 &1 110 � v � �1 N 0 3 , ILEG ENO /. New tan/v _ 2 reg. .13, 3 4 0 y al, 'q� 2. E,rist• 3 06, 010 �� Total s�araye capacity 33, 350 to �06.6�, ,3. h'ed.Tac�et subrneryed pvm�1 4 ///0/ /z �dischar9e� Ci with leap defector X120 s¢ heavy dufji i-r-.an . . .hole .pi-avib�e emergency. valve un oder diswenser. �i 4. 4 Fill lime , with 2 ''vent, cDa ria( vrrecovPrysys_ erns fight `ill adapter CaP offoo 1770nhole- Et.i3•e �- S. t?rope&y Line C�a I ,/ l"• ercavation sA27l16e as close as possible_ fo \ tJ •c. �3 I 2..BackFll avith clean coarse sar7rf fo a /77-7,47 4//77 o'PlIP/1-7 \ \ \ © of /-6 i veli cor,7Pacted fo create a cvsfiion. .7op Nr1fh \ D `•4 clrari� well graded lrc sIones over �3 '� bar k fvn yra�eL / F ll corn/�acfecl m a marines sucfi'asr2o/ fo .q/ama9� \ Ex/sf• um isL. y th c faf-,ks a their a��erfur�ar�ces ohm 3, /Yolo' down assembly shall consist oF2 SfeP! ioPe Et.12.0 �9Tmin.,namir7�rl sfrenyfh) with 2 coats hod asphalt reo>renP /7os� covesFcs�d� , fuihbucyle � �S sf4! 70,03 _-' /ioG� a17eb0o- 5- 0 ,.L9 coatPo/ wrth 2C6ats hof. asphalt where �rpas6,o/ fo 51ro0nci, : .. .. :. :..:. C A /l/ A L .S T - � % .a, f!C! materials, erection �' vvor/�mar�s/iip steal/ be '_ S / T A I`1 / l'o" ire /IV//,6 ffic lafest standards oFfhP Ik64\-- --- - - - - — 16 ARECEIVED 6.Concrete slre,791h shall be 3,000Psi a728 odays air d 4� W .,�• ern1rairneciK,< % f), ¢ , rnax. sl�mw. '80 APR 14 P253 r> . o�:o or :vrnith a !ti/i17e=n a`FU/avit aCt'est�n ds fo the mi;r � / pitch. top of slab - - � CITY CLERi('S OFFICE ,4IfL` Toward na_ f�a/ch erisf - strength of concrete ,poured, SALEM MSS. feral drainage paving as —c lrIWII 56.711 be 41,65 -feel oz V re9virecl d �r�osea/ shah surface shall hav ,a. broom N 6�6 Gr/W/xl Finish Q ^ c N I^ e �— Gravel til& ^f `b Uf2LI - T OA TA see note 2, � t 27anks- K, 67o gv 1,farnk Q 0 f-ofaL uph�Ft = � 67ox2 xo.�337xD.o62¢= llz k � � � � W/ of .6 "Conc . pad surFacP (sx�& '�_ `il Standar steel r o.isXo,sr2sxie 34hQL z T n k ell,, h UL � . . : ; ; I „ /2 sub 7 e°rc�PdF2s'xi�) c „� Q 2 label a c/ ,47 , = -� (o,is_D.o62q)zs r /g 37k 7'O"0X23 • , O . f�i"ou�l� oat - r �� Tarnh3 _ o;oi 717X23. 1 c,5•a7 Q 12 h h O II • � � ( 0624 (2S 1 8 O 3 'S7TX23X2 uFfillb t - hly_ 4 4irey«riicd pPi tan/z r Y25-2 l a7 6=4 o.c. t_ SFP nee 3 tc F O : CJ /V O A T I U N . _ 1-6 a .. . • N COA���i Conservation Commission N Salem, Massachusetts 01970 Telephone (617) 745-5056 `yASSPc'� CITY OF SALEM CONSERVATION COMMISSION WETLANDS HEARING A public hearing will be held as required by the Wetlands Protection Act, G.L. Chapter 131, Section 40, at the request of Richard Salinsky. The prupose of the hearing is to discuss the effects of installing new oil . tanks at the B.P. Station located at 145 Canal Street, Salem, Massachusetts. The hearing will be held on Thursday, April 24, 1980 on the third floor of One Salem Green at 8:00 P.M. a -'I, Bradford Northru Chairman t CITY OF SALEM, MASSACHUSETTS APPLICATION RECEIVED SPECIAL PERMIT WETLANDS AND FLOOD HAZARD DISTRICTS TO APR 14 _P1 :57 CITY CLERK'S OFFICE Applicant: d/f _ �f• /�//u/�� �� SALEM MASS.' Address: �O}/ DO%by 5! PP � City Clerk Stamp � . Telephone: / ¢ S - 5 96 Owner: 1�1' L h 8 / d P. 5 a / f ✓t 5 h V Address Lynnivay , Lynn Ma 5S . T Location of Property: � ¢ S ar/ gl SJ/ ewe // /!// Project Description: y A� tv c')11 T71n ks .Ir75/w1 c76cr? I. It has been determined by the Building Inspector that the above property lies in the following area(s); A. Wetlands District Wetlands ( ) Buffer Zone ( ) B. Flood Hazard District Zone A ( ) Zone A3 ( ✓) Zone V3 ( ) II. Information required includes this application and the following additional information (file one copy of everything with the City Clerk and five copies with the Planning Board; all copies must be stamped by the City Clerk) : A. A site plan at a scale of 1" equals 20' prepared by a registered land surveyor or registered professional engineer and showing at least the following: 1. Lot lines within which the development is proposed and the tie- in to the nearest road intersection; 2 The location, boundaries, and dimensions of each lot in question; 3. Two-foot contours of the existing and proposed land surface; 4. Location of existing and proposed structures, water-courses, drainage and drainage easements, means of access, utilities, and sewer .disposal facilities including leaching fields, if any. Proposed elevations should be noted. 5. Boundaries of all districts, areas and zones as noted in Section I. B. In the Wetlands District, a determination by a qualified engineer of the seasonal high water table, performed during the last two weeks of March or the first three weeks of April. A minimum of two percolation tests for each leaching area shall be performed. C. In cases of flood-proofing or pile construction, certification by a registered professional engineer or architect as to the elevation of flood-proofing measures and as to compliance with the applicable sections of the Massachusetts State Building Code concerned with flood depths, pressures, velocities, impact and uplift forces, and other factors associated with the base flood. Where specific methods or techniques have been previously certi- fied, the Planning Board may waive this requirement. I D. A list of Federal, State, and other local permits required by the applicant. E. Descriptions relative to all conditions applicable in Section III below. III. Conditions (Complete those sections indicated (x) by the Building Inspector) In the Wetlands and Flood Hazard Districts no structure or building, including pipes and wells, shall be erected, constructed, substantially improved, enlarged, or otherwise created or moved; no area shall be paved; no earth or other material shall be stored, dumped, used as •fill, excavated; or transferred; and no sediment shall be caused to be discharged from or onto a wetland, unless all the following condi- tions are found to exist as part of the granting of a Special Permit by the Planning Board (Use additional pages if necessary) : A. All Districts: (X) 1. The proposed use will comply in all respects to the uses and provisions of the underlying District in which the land is located. Yes ✓ No (X) 2. There is adequate convenience and safety of vehicular and pedes- trian movement within the site, and in relation to adjacent streets and property, particularly in the event of flooding of the lot(s) or adjacent lot(s) caused by either overspill from water bodies or high runoff. Y(i S i -3- (X) 3. Utilities, including gas, electrictity, fuel, water, and sewage disposal, shall be located and constructed so as to protect against breaking, leaking, shortcircuiting, grounding or igniting or any other damage due to flooding. (Provide details) l7I/ L �II� CC:1lI�JtfL/s �i r S1�r,Ci,a/I�J TS;yi7a� Fol pr 117 Sf.7���( iOYI Lf''Yb /m�/v tai��wA w ,Ihel PI'Il�s (X) 4. The cumulative effect of the proposed development or use, when combined with all other existing and anticipated development and uses will not obstruct or divert flood flow; substantially reduce natural flood-water storage capacity in the local drainage area; destroy valuable habitat for wildlife including fisheries or shellfisheries; adversely affect groundwater resources or increase storm water run-off velocity so that water levels on other land are substantially raised or the danger from flooding increased. Nc B. Wetlands District: ( ) 1. The proposed development or use shall not include the storage of salt, chemicals, petroleum products or other contaminating substances or discharge of any polluting liquids or materials into streams, brooks or wetlands. (The polluting effects of substances on the Wetlands are to be gauged by the "Rules and Regulations for the Establishment of Minimum Water Quality Standards and for the Protection of the Quality and Value of Water Resources" of the Commonwealth of Massachusetts. ) /VCI -4- ( ) 2. The floor level of areas to be occupied by human beings as living or work space shall be four (4) feet or more above the seasonal high water table. ( ) 3. If the basement floor level is below the seasonal high water table and affords the possibility of human occupancy at some future date, although not originally intended, adequate perimeter drainage and foundation shall be installed to with- stand the effect of pressure and seepage. Furnace and utilities are to be protected from the effects of leaching. (Provide details) Applies ( ) Does not Apply ( ) 77 131. e ab1p ( ) 4. If the lot is to be served by an on lot septic system, the leaching area designed for use, as well as a reserved area for future expansion or total future use, shall be plotted with dimensions on the site plan, and the leaching areas shall not be constructed where the seasonal high water table is less than 4 feet below the bottom of the leaching areas. Applies '( ) See site plan Does not apply ( �) C. Flood Hazard District (all zones) : 1, ( ) 1. The floor of the basement, or if none, the lowest floor of new construction or substantial improvement of structures for residential uses shall be at or above the 100 year flood level. ( ) 2. The floor of the basement, or if none, the lowest floor of new construction or substantial improvement of structures for non- residential uses shall be at or above the 100 year flood level or the structures shall be flood-proofed to that level in compliance with the applicable requirements of the Massachusetts State Building Code. Flood-proofing measures shall insure that the structure is watertight and that structural components have the capability of resisting hydrostatic and hydrodynamic loads and the effects of bouyancy. T i -5- D. Flood Hazard District, Coastal High Hazard Area (Zone V3); ( ) 1. New structures or substantial improvements shall be located landward of the reach of Mean High Tide. ( ) 2. New structures or substantial improvements shall be elevated on adequately anchored pilings or columns, and securely anchored to such pilings or columns so that the lowest portion of the structural members of the lowest floor (ex- cluding the pilings or columns) is elevated to or above the 100. year flood level. Space below the lowest floor shall be free of fixed obstruction. (Provide details) Q?ei ( ) 3. The support of new structures or substantial improvements shall not be, in whole or in part, by the use of fill. (Provide details) tie) (I ,01 1, Ul m IV. Procedure The Planning Board shall, within 7 days after the filing of this application, transmit one copy of said application, plans and all other submitted information to the Inspector of Buildings, City Engineer, Board of Health and Conservation Commission who may, at their discretion, investigate the application and report in writing their recommendation to the Planning Board. The Planning Board shall not take final action on such application until it has received a report thereon from the Inspector of Buildings, City Engineer, Board of Health and Conservation Commission or until thirty-five (35) days have elapsed after dis— tribution of such application without a submission of a report. The Planning Board Shall hold a Public Hearing on said application as soon as possible after receiving the above reports, in accordance with Chapter 40A of the Massachusetts General Laws. The Planning Board shall notify the applicant in writing of its decision on the special permit. The decision shall document the proposed development or use and the grounds for granting or refusing the special permit. The i _6_ Planning Board may, as a condition of approval, require that the appli- cant give effective notice to prospective_purchasers, by signs or by recording the special permit at the Registry of Deeds, of the wet- land or flood hazard conditions associated with said premises and the steps undertaken by the petitioner or his successor in title to alleviate the effects of same. L.---_' Signed Title Date l t4 � O _r h o� it17.1t 55cICIIIult5 �a w3� "�� ��l�ztlllittg �oarl (911P �aIpm Grrpn REQUEST FOR REVIEW COM ENTS SPECIAL PEK1IT DATE: rc `/. /7� T TO: ( ) Building Inspector Conservation Commission ( ) City Engineer ( ) Other: ( ) Board of Health Attached please find the application referenced below. The Planning Board requests that you review this application relative to Section VIZ of the Zoning Ordinance. We would appreciate your completing the form below and returning it to us. Notice of the public hearing for this application will be forwarded to you. O WETLANDS & FLOOD HAZARD DISTRICTS ( ) CLUSTER DEVELOPkENT ( ) PLANNED UNIT DEVELOPMENT APPLICANT: �coG PROJECT NAME & ADRESS: CONTACT PERSONS AND PHONE: Applicant: City: COMMENTS DUE BY (Failure to comment.within 35 days shall be deemed lack of opposition.) ( ) Concur with proposal (Explain on reverse side) ( ) Need more information (Explain on reverse side) ( ) Cannot concur with proposal (Explain on reverse side) Comments included REVIEWER'S SIGNATURE TITLE DATE - 3 - W-TLAND PROTECTION ACT (( IIR0N?1 'NTAL -DATA FORM 1. All parts of this form are to to filled out by the applicant or hist agent under the provisions of G.L. C. 131 s. 40. 2. Where a section is not relevant to the application in question, the fiords "Hot Applicable" should be entgred on the appropriate line. NAIOF APPLICANT l�D h� Y. �- f`l• /� [JYY1��, - 'DRESS C? APPLICANT U I MUNICIPALITIES WHERE ACTIVITY IS PROPOSED AND NOTICE IS FILED DESCRIPTION OF PROPERTY INVOLVED IN Sae 511-e PLarr on IVocu. APPLICATION (including the dimensions 01'L7a,71ss fa(faf;ovt d� v� of any existing buildings, decks, marinas, 2r)c/v31j existing cesspools) (� DESCRIPTION OF MODIFICATIONS PROPOSED ON TFIE SITE, including grading, dredging, removal of vegetation, etc. del _.A. NILS 1. United States rDepartment of ;s c. All Agriculture Soil Types (show on map) ` 2. Permeability of soil on the site. (Dates of testing) 3. Rate of percolation of water through the soil. (Dates of testing) Oak B. SURFACE WATERS . 1. Distance of site from nearest surface water (Date -of measurement) 4 - y a 2. Sources of runoff water PP �; cablP 3. Rate of runoff from the site 4. Destination of runoff water v 5. Chemical additives to runoff water on the site C GROUND CDVTr R 1. Extent of existing impervious n ground cover on the site 2. Extent of proposed impervious. �d wejo (l.c, 6/�p ground cover on the site .3. Extent of existing vegetative cover on the site C7 4. Extent of proposed vegetative cover on the site D. TOVOGRAPHY 1. Maximum existing elevation on site 13 ' g Ft 2. Minimum existing elevation on site 2 , 0 F!•. 3. Maximum proposed elevation of site A4J . 4. Minimum proposed elevation of site /1/u/ 1ppli,c ahC•v 5. Description of proposed change in topography NO V1 E. -GROUND WATER 1. Minimum depth to water table on site (at time of filing) Ajs Spe � 1 2. Maximum depth to water table on site (at time of filing) ;dip • faf;anS 3. Seasonal maximum ground water elevation WATER SUPPLY -�- • c�ty 1. The source of the water to be 6ravided to the site WV 2. The expected water requirements (g.p.d.) for the site 3 009 pJ' ,1 S. The uses to which water will be but Se r vr'cP S faf o h G. SEWAGE DISPOSAL 1. Sewage disposal system (description and location on the site, of system) M� ' c' �'a 2. Expected content of the sewage effluents (human waste, pesticides, N �/ � �� detergents, oils, hea v metals, of a eca other chemicals) 3. Expected daily volume of sewage hof 3/.3191;(zLIP r. SOLID WASTE 1. Estimated quantity of solid waste No ;k7�1-a ),),L; c a to be developed on the site 2. Method for disposal of solid wasteoF app( ; , 7hle 3. Plans !for recycling of solid waste te X. BOAT YARDS, DOCKS, MARINAS 1. Capacity of marina (number of boats, running feet) 2. Description of docks and floats (site, dimensions) 3. Description of sewage pumpout facilities (type of waste disposal) 4. Description of fueling facilities and fuel storage tanks N�f aj� �icaIV/P 6 5. Description of fuel .spill prevention yva f .alp �• a btu ' measures and equipment { J. IYDACT OF PROPOSED ACTION APPLIED FOR . 1. Effects' on plant species bt (upland and marine) 2. Effects or. marine species (shellfish, finfish) k), app( 3. Effects on drainage and runoff Not 412p l«a "ke i 4. Effects on siltation o= suj face aete_s 5. Effects; on groundwater quality �1a I app �ii a b I v 6. Effects on surface water quality -;IPPI"C d to ,I K. ALTERNATIVES TO PROPOSED ACTION ' L. Describe alternatives to the . requested action 2.: Describe the benefits of the requested action over the alternatives No �!'j' '` 6�Q TUE MWONNEALTH OF PiASSACHUSETTS Depa2tment o;( Env.lhonmentat .nua2tty Fnn.Lneehinn P!etnonotltan Boston - Nontheast genion 323 Hev) Boston Stneet, Mobuan, HA 01401 727-5194 DATE: April 22, 1980 TWIN: Salem FILE ,NUPIEER ArSqf,"IED: 64-61 This Depattment is in nece.Lpt off(, an ap.pticatl.on under Cenehat Laus , Chaptert 131 , Section 40. Appt cant: Robert M. Rumpf . . . . . . . . . . . . . . 101 Derby Street Salem, Mass.'. . 01970 . . . . . . Ownue. ob Land (i4 R44enent) : Richard P. Satinsky, B P Co.., 319 Lynnway, Lynn, MA This ptofect it .located on:. . 145 Canal Street ( J Pio jite numb.en has been asst,Rne�4 since the 4it.no as received is considered .i.neomPtete. Ptease submit the ;Jottowznn : Notice o;, Intent ( J Ptans Locus ?lap ( J C;5nnect F,:/ m ( J .Thomas F. McLoupht.Ln Regionat Envitonmenta.F+ En,q�.ne:.n 11et&opotttan Euston-Noxtheast P.ecLon TFR/Ekat/.Cd ee: Conservat' on Commission . . . . . . . WETLANDS PROTECTION ACT M- MASSACHUSETTS C.L. C. 131 s. 40 r NOTICE 02 ?:i ANT ' \ ill. p-ta of this form and thA attache{ Eaviro=ental Data Form shall be completed e under the pains and penalties of perjury. Incomplete filings may be rejected. DATE: Conservation Commission of (City/Town): Sea/eiYi 1. Notice is hereby given in accordance with the provisions of Massachusetts -C.L. c. 131, s. 40 that the proposed activity described herein is within the jurisdiction of (City/Tocrn) at 14-5 Street Most recent recording at the Registry of peec15 in- S,11eir-7 , Book62-32 , Page :P 3 Certificate (if registered) ' - 2. The land on which the work is proposed to be done is owned by: t3 P L-6 . NA-�E(6) R/C.1iaic/ P• .Sari n ADDRESS 3 /9 Lynnivyy Lynn,�­lass. 3. The Applicant submitting this Notice is: NAME n o�e/�-� r7ymADDRESS / 01 Derby Sf. Sa�e.� t TELEPHONE 7 4 (Optional)The following person is hereby designated to represent the applicant in matters arising hereunder: Name do 1 Address civ Telephone 4 4> Plans describing and defining the work, included herewith and made a part hereof, ere titled and dated: lVew Od 1 arms 1';�sfallater �'or BPCas Sfaf;on - 3/zs/aC� 5. Identical material has been submitted by certified mail as follows: Original to Conservation Commission (Date) 41/4 / 8C) Three copies to appropriate regional office of the Department of Environmental Quality Engineering (see map for regions and addresses). Date Q / /4 NO ICNortheast V Southeast Central Western — 2 6. Has the required $25.00 filing fee, payable to the city or town, been included with the submission to the Conservation Commission? e5 7. Has the Environmental Data Form been completed and submitted with each copy? Yes 41 8. Has locus map (8;1" x 11" copy of USGS topographic sheet with the site marked) been included with each copy? 9. , (A)Have all obtainable permits, variances, and approvals required by local by—law been obtained? /ye (B)If they have not been obtained, have they been applied for? Ye 5 If yes, include with this Notice of Intent any information wh ch has been'submitted tai[^ such app.l;;.a is^v which is necessary to describe the- effect of the proposed activity on the environment. Alo F f-e 10. (A)Is the site of the proposed wc_k subject to a wetland restriction order recorded pursuant to G.L. c. 131, s. 40A, or G.L. c: 130, s. 105, by the Department of Errvironmental Management? Yes No ✓ Do not know .(B)Is the site of the proposed work in, or within 100 feet of: a coastal dune /)o ; coastal bank no ; coastal beach no ; salt marsh-no ; land under the ocean 12o ; a salt pond n o ; anadromous/catadromous fish runes; do not know 11. Signature(s) of owner(s) o the land (if by agenj or option holder, written auth •-i( zation must be attached) 12. What is the purpose of the proposed project? -5 to So L;h e fo 6e sold Z �efai( 13. I HEREBY CERTIFY UNDER THE PAINS AND PENALTIES OF PERJURY THAT THE FORGOING NOTICE OF INTENT AND ACCOMPANYING NVIRONMENTAL DATA FORM ARE TRUE AND COMPLETE. Signature of Ap` -cant Date 1